12 Common Mistakes to Avoid as a Public Health Consultant in Africa

Dr Moses Simuyemba leading an inception meeting to get stakeholder input and buy-in at the beginning of an assignment, Botswana

m y previous article I outlined some strategies that can help you to be successful as a public health consultant in Africa. In this follow-up article I point out some key pitfalls to avoid.

Public health consulting in Africa is a challenging field that requires consultants to navigate complex social, cultural, and economic factors that affect health outcomes in different communities. While there are many strategies that can help consultants succeed in this field, there are also certain pitfalls to avoid. Here are 12 things to avoid as a public health consultant in Africa:

  1. Not delivering on time and taking on work that is beyond your exepertise

Meeting deadlines is critical in any consulting work. Failure to deliver on time can result in missed opportunities, loss of credibility, and damage to relationships with stakeholders. I have often been tasked to take on work because a previous consultant failed to deliver on the work or they have taken too long to deliver on it. This often arises at times by taking on work which may be beyond your level of knowledge and expertise. It is okay to not take on work that you are not well-qualified for.

  1. Using a one-size-fits-all approach

Using a single approach to address complex public health challenges can be ineffective or even harmful. It is essential to tailor interventions to the local context and to take into account the unique needs and challenges of different communities.

  1. Not being conversant with the local context

Public health consultants who are not conversant with the local context risk developing interventions that are not well-suited to the needs of the community. It is essential to understand the social, cultural, and economic factors that affect health outcomes in different communities.

  1. Not getting buy-in

Building strong relationships with stakeholders and gaining their buy-in is critical for the success of any public health intervention. Failure to do so can result in interventions that are not well-supported by the community, which can undermine the effectiveness of the intervention. As a consultant you are often only there for a short period of time and it is these stakeholders who will make use of your input and carry the work forward so it is critical to engage them throughout the process and get their buy-in.

  1. Inadequate engagement of key stakeholders

Engaging key stakeholders is essential for successful public health interventions. It is important to work closely with local healthcare providers, community leaders, and non-governmental organizations to build their capacity to work towards better health outcomes.

  1. Not looking for and involving expertise you do not have yourself

Public health challenges in Africa can be complex and multifaceted, and may require expertise that the consultant does not possess. It is important to involve other experts and stakeholders who can contribute to the development of effective interventions.

  1. Shoddy writing

It does not matter how technically proficient you are, if you cannot express your thoughts well in writing you will not succeed in consulting work. Poor writing can undermine the credibility of a public health consultant and their work. It is important to invest time and effort in developing clear, concise, and well-written reports and other documents. Invest in improving your writing skills.

  1. Spreading your efforts too thin and taking on too many jobs at once

Taking on too many jobs at once can lead to burnout, decreased quality of work, and missed deadlines. It is important to manage your workload effectively and to prioritize your assignments.

  1. Not building a team

Building a team can be critical to the success of public health interventions. It is important to identify and recruit team members with diverse skills and expertise, and to work collaboratively towards common goals.

  1. Over-pricing yourself

Over-pricing can lead to missed opportunities and damage to relationships with stakeholders. It is important to price your services competitively and to be transparent about your pricing structure. Check what other consultants charge for similar services in your setting.

  1. Underpricing yourself

Under-pricing can lead to financial difficulties and can undermine the perceived value of your work. It is important to price your services appropriately, taking into account your skills, expertise, and the level of effort required for each assignment. Under-pricing can also put pressure on you to take on more work, which will be detrimental to the quality of your work.

  1. Not building in enough time to do the assignment well

Public health interventions can be complex and time-consuming. It is important to build in enough time to conduct thorough research, analyze data, and develop effective interventions. Be open to negotiate the timing of deliverables with your hiring organization and advise on realistic timelines that will enable you to do a good job.

In conclusion, to be a successful public health consultant in Africa, it is important to avoid these 12 pitfalls. By delivering on time, tailoring interventions to the local context, building strong relationships with stakeholders, engaging key stakeholders, involving diverse expertise, investing in clear and effective writing, managing workload effectively, building a team, pricing services appropriately, and building in enough time to do the assignment well, public health consultants can have a huge impact.

How to Thrive as a Public Health Consultant in Africa: 7 Strategies for Success

Dr Moses Simuyemba in Dakar, Senegal, working on Covid-19 programme

As a public health consultant, I get a lot of requests on how to be successful in this industry and deliver value. This article is a summary of some of teh key lessons I have learned over the years, working in Public Health in most regions of Africa.

Public health consulting is an important aspect of healthcare in Africa. Public health consultants work with government agencies, healthcare organizations, and other stakeholders to improve the health outcomes of communities across the continent. As a public health consultant in Africa, there are certain skills and strategies that can help you succeed in this field.

  1. Develop a deep understanding of the local context

To be a successful public health consultant in Africa, it is important to have a deep understanding of the local context. This includes understanding the social, economic, and cultural factors that affect health outcomes in different communities. It also means understanding the local health system, including its strengths and weaknesses, as well as the resources that are available. What work in the West may not be as successful in Africa, due to many contextual factors which differ from region to region and from country to country.

  1. Build strong relationships with stakeholders

As a public health consultant, you will be working with a wide range of stakeholders, including government agencies, healthcare providers, community leaders, and non-governmental organizations. Building strong relationships with these stakeholders is key to success in this field. This means developing trust, being responsive to their needs, and communicating effectively. Delivering on time is another key aspect of building such relationships.

  1. Use evidence-based approaches

Public health consulting in Africa requires a strong focus on evidence-based approaches. This means using data and research to inform decisions, and developing interventions that have been proven to be effective in similar settings. It also means staying up-to-date with the latest research and trends in public health. You thus need to be widely read and up to speed in your area of expertise.

On another mission in Botswana, conducting key informant interviews to help with developing an M&E framework for Botswana adolescent and young people (AYP) programming
  1. Be flexible and adaptable

Public health challenges in Africa can be complex and multifaceted, and they often require a flexible and adaptable approach. This means being willing to change course when needed, and being open to new ideas and perspectives. It also means being able to work effectively in a range of different settings and contexts.

  1. Collaborate with local partners

Collaborating with local partners is essential for success as a public health consultant in Africa. This includes working closely with local healthcare providers, community leaders, and non-governmental organizations. It also means building capacity among local partners, so that they can continue to work towards better health outcomes even after you have moved on to other projects.

  1. Communicate effectively

Effective communication is essential for success as a public health consultant in Africa. This means being able to communicate complex ideas and data to a range of stakeholders, including those who may not have a strong background in public health. It also means being able to communicate effectively across cultures and languages.

  1. Stay committed to the mission

Finally, to be a successful public health consultant in Africa, it is essential to stay committed to the mission of improving health outcomes for communities across the continent. This means being willing to work tirelessly, even in challenging circumstances, and being motivated by the knowledge that your work is making a real difference in people’s lives.

In conclusion, being a successful public health consultant in Africa requires a deep understanding of the local context, strong relationships with stakeholders, evidence-based approaches, flexibility and adaptability, collaboration with local partners, effective communication, and a commitment to the mission. By focusing on these key areas, public health consultants in Africa can make a significant impact on the health outcomes of communities across the continent.

The Water Knows Their Pain

Lac D'Annecy, France, Lake Annecy

Standing on the shores of Lac D’Annecy, France

After class and dinner at Les Pensieres Global Health Centre in Veyrier-du-lac, France, I decided to walk back to the Encore Hotel where I was lodging. It was a nice twenty-minute walk and most of the way you could walk right by the boardwalk over Lac d’Annecy (Lake Annecy). It always made for a nice way to end the day with the late sunset over there compared to Southern Africa where I am from. The sun was still out though it was past eight in the evening.

I was walking briskly, headphones in my ear, listening to classical music, hands in my coat pocket, hoodie over my head for the cold. About half way through the walk I noticed what looked like a castle in the distance across on the opposite shore of the lake, though it could have been a church. I had walked this route for over a week now and had never noticed it.

I stopped to take a picture. But as I aimed my phone in that direction to frame the shot a sombre mood suddenly fell on me. I think it was the view of that castle in the distance, tantalisingly close yet so far, the empty boats tied by the lakeside and the classical music I was listening to that brought in my head the thought of a migrant with a family on a boat.

I imagined that migrant looking afar off in the distance at the castle and thinking “finally, we are almost there, almost in Europe.” He had a family, young children and a wife on the boat. The next image in my head, that I resisted, was the image of his children in the water, drowned, so close to shore.

I did not take the picture I had intended to. Instead I switched the camera to selfie mode and took a picture of myself, with the lake in the background. The castle was too small to see in the selfie. The reason I took that selfie was to remind myself of what I thought and felt that instance when I thought of that scenario.

I felt a heaviness I cannot describe. I imagined if those children on that boat had been my own. I thought of all the migrants whose children had lost their lives at sea trying to find a better life. I thought of all the parents who had died trying to make a better life for their children in their home countries. All their dreams, all their hopes, lost at sea.

Yet there I was with my latest smartphone taking a picture, coming from eating a three-course meal cooked by a world class chef, learning about vaccine science from some of the world’s leading scientists, meeting people from well over fifty other nations during the course.

There I was, not realising how privileged I was. Not realising how much blessing I had, how education had made such a big difference to me and others like me. There I was, not appreciating the things that other people have died to have for themselves and those that they love.

I had the luxury to complain about inconveniences such as the hotel not being able to do laundry or not serving dinner, or the internet being slower than I had expected, or the weather being so cold compared to home. I could get to my room and cuddle into a warm bed, out of the cold.

I was standing on land that people died trying to set foot on – and only their corpses experienced its cold, unwelcoming embrace.

What of them? What of those children in that war-torn country who have no warm bed, no food, no education, no healthcare? What of them? Those that have no parents, no money, no warm clothes? What of them – faced with despair and fear all day long?

They dreamt of starting a better life. They only wanted a fair chance to have a decent life. They wanted what every man wants – to live well and to live free. They wanted hope. But all they got was death. Death and the scorn of those who enjoy such a life. Those who are more privileged. Those who see themselves as worthier to live and to live well.

We do not see injustice until it affects us. Then how unfair it seems. How we look to the world to see our plight and fight for our cause. But all we get too is silence. The same silence we so loudly practiced ourselves. All we see is injustice when we are the ones affected.

Yet, every life matters. Every one of those drowned souls is important. They might have died in those waters but their dreams and hopes carry on in the millions they have left behind.

Their blood cries out to those that led them to that death. No, not the boatmen or smugglers that promised them a safe ride across the rough seas, but the politicians and leaders that promised them a better life and instead gave them hell.

Their blood cries out to the conglomerates, the oil merchants and the mineral gobblers that value money over human life. Those that have their gold covered with human blood. The western leaders that see Africa simply as there mine and source of raw materials, blind to its people and their plight…singed of all conscience.

Those are the real villains. Those are the real scum…and those that protect their interests at all costs. They are the ones to be really held accountable for it all. Their day will come. God will require it of them.

I took my selfie, looking serious and thoughtful, nor a smile on my face, and continued my walk to the hotel. My pace had changed. It was heavy. It was deliberate.

I said a prayer in my hotel room and asked:

“Lord, when will it all end? And what am I to do till then?”

Africa, Commit To Excellence!

African map, african continent

African continent on a world globe

Efficiency, consistency and excellence are things that we as Africans always seem to struggle with. As the world heads more and more towards automation and precision you cannot help but wonder when Africa will catch up. We always seem several steps behind and that translates to a decade or more for most innovations.

Simple things seem to fail us. You will be hard-pressed to find an African country or town where the public transport is predictable and runs like clockwork. Using public transport in Africa to commute for time-sensitive things like work requires you to build in considerable lead time into your journey, something that inevitably contributes to inefficiency and lower productivity of the workforce who show up late, leave home very early, get home late and so on. This undoubtedly must affect quality of life and work-life balance, for example.

Then there is the lack of predicable and consistent systems that characterises most of our way of doing things. Endless queues to get simple things done such as acquiring a national identity card, passport, driver’s license and so on are the norm. The ensuing corruption that this promotes either a result or a causal factor, or likely both – your guess is as good as mine. In some countries you can do or at least start most of these processes online and get notified via email and so on.

A constant reminder

At my workplace I am confronted daily by caregivers with patients in the hospital wards gathering outside my window, gossiping on family matters and smoking, much to my annoyance and repeated intrusion to ask them to keep the noise down or not smoke outside my window. Who can blame them though – there is no shelter or decent sitting area for them to use. Meaning I also have to deal with dodging stagnant water and watching clothes drying outside my office window as they use the tap outside to wash their clothes and the hedge to dry them. Yet everywhere you look in the premises there is endless construction of more wards and hospital facilities. Yet not a thought to the caregivers.

This is in stark contrast to my recent experience in Bahrain, a small island state in the Middle East. The public transport runs like clockwork. People seem to know what they are doing and go about it with purpose and efficiency. It would seem there is a place for everything and everything in its place.

Coming from my setting, it was staggering to see the efficiency with which nurses, cleaners and all worked in the hospital. Then there were the beddings, towels, face masks, protective gowns and gloves that were available for caregivers of patients in the corridor storage outside the ward for them to get and use at will. We joked that if that were back home the caregivers would have collected those things and taken them home. You would likely notice on everyone’s clothes linen and towels marked “Bahrain General Hospital” or the like. That is if the caregivers ever got hold of them in the first place. Very likely it would be the hospital employees, doctors and nurse’s homes where you would find those beddings and linen.

Contrast this to most African countries where gloves, let alone face masks are hardly enough to cater for the health workers themselves. Shortages of basic supplies and drugs are the order of the day, partly due to “lack of money” as we are told or just lack of proper inventory management systems at times. One could argue that we misuse even the little money that we have much of the time, with some drugs and supplies expiring on shelves.

Lack of resources in not our biggest challenge

Some might say this is an unfair comparison, after all Bahrain is far wealthier than my own and most African countries. But I say these matters go beyond wealth. Nigeria is a case in point. Wealth is no factor there yet look at how it is in tatters when it comes to such things. Perhaps you could argue that South Africa is a good African example, but even then, not consistently. Two other African countries that come close are Botswana and Rwanda. But all seem far from ideal when compared to places like Bahrain, the UAE and Europe, for example. I do not mean to say that all is rosy and perfect in these places, but clearly, they get it right more times than we do.

By my observations, the problem is multifaceted. You cannot talk about such matters without pointing out the corruption that is in Africa. That, no doubt, is a major contributor to what is going wrong. But like a vicious cycle it is also perpetuated by the same situation. The problem though is not the corruption. There is something far bigger that is the problem.

A culture of excellence is lacking

I say it is a lack of a culture of excellence amongst us as Africans. We do not always seek to do and give our best in what we do. In fact, the opposite is often true. The moto seems to be to get as much money for doing as little as possible, whether by doing little work or by other unethical means, starting with the top leadership in our political circles. This inevitably trickles down to the entire population.

But, as Africans, we do excel when placed in countries and institutions that require such excellence of us. Even in our own countries, those who work for international organisations that have such work ethic will attest to this. Such organisations often stand out in an environment that is otherwise mediocre.

So, as individuals we have what it takes. What is lacking is making such work ethic and commitment to excellence an intrinsic part of all that we do, whether we are being watched to do it or not. Indeed, whether we are being paid for it or not. We need to start taking pride in doing things well and building our reputation for doing things well.

It starts with leadership at all levels

But, no doubt, that is easier said than done. In my opinion, it starts at the very top. At national level it starts with the president. Paul Kagame of Rwanda, love him or hate him, is one good example. His unwavering commitment to making this country excel and willingness to do whatever it takes is paying off as Rwanda is being recognised globally for leading Africa in many areas. That from its dark history of genocide only a few decades ago.

I like to call him a “benevolent dictator” who has his country’s best interests at heart. Perhaps that is what much of Africa needs. Democracy, in my opinion, has not been good for us at all and has probably contributed to much of the corruption we see as greed and the need for votes and short-term considerations overshadow all else.

If the president or whoever is on top leads the way others will follow. The late Levy Mwanawasa of Zambia was a good example too, though much of what he did has been undone by his untimely death and subsequent cluelessness and greed of ensuing leaderships. Zambia would be in a very different place had his kind of leadership and low tolerance for corruption continued.

So, if the top leadership has that ethic it trickles down to the members pf parliament and the ministers and from there the permanent secretaries, the directors and so on.

But even in other institutions the same is true. The top leadership matters and whatever goes on in an organisation has to, at some level, reflect the level of thinking and capability of those who lead it. Thus, excellence starts from the top in all things, it cannot be sustained from the bottom. Leadership is key.

Our education system needs an overhaul and fresh thinking

It also starts with our education system and its duty to implant the right values in our children. If taught from an early age that we must do things well and give our best at all times in all that we do, Africa’s younger generations can do a lot more than those before them.

But herein lies the problem. This “overhaul” is uncomfortable and undesirable for some. The old guard will not leave quietly. Those that benefit from what is wrong will not relinquish their power and influence. For some it is simply lack of ability and not being willing to admit that they have done all they could and it was not good enough and that others should try.

I have seen this attitude kill us, politically, academically, scientifically, business -wise, you name it. But it can be stopped. It just takes some radicalism. It just takes some fresh thinking. It just takes some risk-takers to get the ball rolling and instil that vision.

Africa, commit to excellence in everything

My call to Africa is “let us all commit to excellence in all that we do and at all times.” Change will come. Wakanda can be our reality, even without vibranium.

In Africa Lies Our Future and Prosperity

Visiting the USA for the first time recently, I left with mixed feelings. But mostly, feeling blessed that I am from Zambia, a peaceful nation where one has as much opportunity for success as one can have.

I met lots of Africans, mainly Nigerian, Ethiopian, Somali and Ghanaian. Sadly, they were the cab drivers, waitresses and hotel cleaners. One waitress told me at breakfast whilst serving me, when I asked her if things were going well for her:

“It’s been a struggle. I came here looking to live like you, attending conferences and being a professional. I have spent half my life here…since I was 18. I wanted to study, but had to support my family back home. I haven’t given up though. Am still pursuing my degree.”

She felt the courage to talk to me after I had tipped her when settling the breakfast bill. So it was, the Ethiopian cab driver said he was working several jobs just to survive. He was thinking of going back home. It was no longer worth being there, he said.

Everywhere I went I saw Africans and other immigrants working the tough jobs. Many looked broken, uninspired, getting by. Why are they here, I thought? Why not just go back home? Why are so many Africans struggling to get to the USA? But then it hit me that some have little choice – they are running from poverty, persecution, war, oppression.

But I couldn’t help but feel many are too ashamed to go back home. How can they go back home with little to show for the decades spent overseas? They will likely be laughed at, ridiculed. Or so they probably think. Better to stay. Yet, I can’t help feel that some do have a choice…that they could make more of themselves back in their home countries.

I remember as a medical student studying the USMLEs – the exams that would allow me to work in the US as a doctor. I soon gave up on that dream – realising that in Zambia lay my success and opportunities. I have never desired to work outside the country since, especially not in Europe or USA.

‘’Why be a second class citizen?’’, I thought. Whether I get citizenship or not, I would still be a foreigner…away from home, with limited options and missing my homeland.

That this was my first visit there is a testimony to my lack of excitement about it. Africa is my turf. I can travel within Africa and never get tired of it. After three days in the US I was already homesick. I went to the shopping malls, and found nothing special that I could not find in any developed African city. The scale of things was bigger, but alas nothing more.

I don’t mean to speak ill of the US or of anyone from Africa living there. I just love my Africa. I wish its people would take pride in it. I wish its people would thrive in it. I wish they would work to make it better and not leave. I wish they could see the potential and opportunity in their land. I wish they could see that slavery is not just physical. It is also economic – and for many that is the reality there. They are slaves to the economy – working to live. No life in their years, only years in their life. Yet the consolation perhaps is that it seems that is the way to goes for all over there, American or immigrant. Money rules and life is spent trying to get it…more and more of it. Yet it is never enough. All in all, am happy to be African. I am happy to be living in Africa. When I spoke of home and missing it, many I met were almost brought to tears. “Don’t do that to me” the Ethiopian shop assistant said when I spoke of wanting to get home to take pictures of flowers in my garden with the macro camera lens she had helped me purchase. She missed her home and didn’t want to cry. I felt for her.

Yet, I realise not everyone is blessed to be in my kind of position…educated with choices. What can Africa do to change that? Everyone should have choices and opportunity. Africa, what must be we do?

It starts with you and me. Africa, let’s be the change we want to see. We can do it! We shall do it!

God bless Africa and its people, wherever in the world they are. Shall a man run away from his poor home and go to seek the pleasures of his friend’s wealthy home? Should he not stay and make his home better instead so he can enjoy his own pleasures. Barring war and natural calamity, political persecution and such, I see little reason for the fight to get to the States or Europe.

But that is my very biased view, I realise that the matter is more complex. Perhaps it is the optimist in me, the persuasion that if you want to succeed bad enough it does not matter where you are, you will find a way. How come others are succeeding in the same environment?

Part of the reason I have not ventured much outside Africa, apart from much of my work being in Africa, is that I detest the prospect of applying for VISAs to go overseas. I joked once to a colleague that I had to fill out more paperwork to go to Europe for a week than I did to get employed at the University where I am based. It irritates me that it is assumed I want to stay overseas forever when I apply for a VISA and have to give every proof that I will come back!

What makes them think every African wants to stay there forever? Oh yes – the many Africans that have stayed there forever, legally or not. None-the-less, there are plenty that do not want to stay there forever.

Yet, isn’t it ironic that many who come to Africa from Europe or the USA never want to go back themselves? They love the weather, the huge houses and massive gardens. They love the easy pace of life here. I have nothing against that – they are most welcome. I just wish more Africans would appreciate all those things and realise that they are blessed…and cherish it…and exploit it. Our opportunity lies in Africa! Our future lies in Africa!